At issue is Obama’s plan to guarantee female workers — even those employed by faith-based hospitals, universities and charities — free access to birth control. Critics had attacked an earlier version of that plan because it required employers to cover the cost. In an effort to ease those concerns, Obama shifted the cost of the contraceptives from the employer to the insurance company.

The “accommodation,” as Obama called it, satisfied a number of the critics, including some Catholic healthcare groups, but Republicans and the Catholic Church rejected the compromise. The critics note that the change won’t help self-insured institutions that object to birth control — a sticky issue the administration has yet to work out.

Blunt’s amendment would have repealed the mandate on faith-based nonprofits, and also extended waivers to any group or person who objects to the coverage requirements for either religious or moral reasons — an approach Democrats argued would go far beyond birth control.

The Republicans said the debate centers on the constitutional guarantee of religious freedom. Democrats have countered that it’s an issue of women’s health.

“This is a women’s health issue,” Pelosi said. “It’s a matter of conscience for each woman, her doctor, her husband, her family and her God to make her own decisions. And as a Catholic I support the right of a women to make that decision.”